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New URMC Program Aims to Help Patients Following Significant Weight Loss

Life After Weight Loss Program is Only Second of its Kind in the Nation

April 20, 2009

Sherrie Neale knew she needed to lose weight but admits her heart wasn’t in it. At 5’4” and 267 pounds, the 41-year-old mother of two says she’d tried every diet, program and gimmick but success eluded her. Then one day in her mailbox came a letter from her father.

“It’s not often I interfere in your life but, if you want to one day see your children walk down the aisle, you need to do something about your life and your health,” he wrote. Neale carried the letter around with her for weeks, weighing his words, knowing he was right. Then she attended a seminar at Highland Hospital to learn about gastric bypass surgery.

Two years later and 130 pounds lighter, Neale’s life has changed dramatically, thanks to gastric bypass surgery by William O’Malley, M.D., at Highland Hospital. And while Neale enjoyed the benefits of a healthier, fit body, the weight loss left her with excess loose skin that she found uncomfortable and unattractive.

About a year after her surgery, Neale had problems with hernias and returned to O’Malley. While consulting with her to treat them, he noted the loose skin that resulted from her weight loss and suggested she consult with a plastic surgeon. O’Malley recommended Jeffrey Gusenoff, M.D., whom Neale remembered meeting at the gastric bypass surgery seminar.

Gusenoff is director of Life After Weight Loss, an innovative University of Rochester Medical Center program for people who have experienced significant weight loss and want to maintain it while improving the way they look and feel about themselves. Only the second program of its kind in the country, Life After Weight Loss focuses on each individual’s nutritional and emotional needs and personal goals, integrating state-of-the-art plastic surgery procedures with lifestyle and nutritional counseling.

Neale consulted with Gusenoff about abdominoplasty, commonly known as tummy tuck surgery. The extra abdominal skin “served as a constant reminder” of her larger self, Neale said. The doctors coordinated their schedules and Neale was able to have it done at the same time as her hernia repair surgery.

One time a size 3XL, Neale dropped to a size 10 after her weight loss and now wears size 6 following her tummy tuck.

“I still look in the mirror and say, ‘Is that me?’ Dr. Gusenoff and Life After Weight Loss put the icing on the cake for me,” she said.

While it feels good, Neale said the journey at times was not easy and requires a long-term commitment to lifestyle changes, including following dietary guidelines, exercising daily and taking vitamins. She also sought emotional support and takes part in an online community of people who have had weight loss surgery.

Life After Weight Loss is intended to address the multiple needs of people after significant weight loss, according to Gusenoff.

“We take all aspects of care into consideration and do way more than just body contouring surgery,” Gusenoff said. “We understand the significant changes that people make through their weight loss. We aim to identify their individual goals and help them meet their expectations. Our philosophy is to help people maintain the benefits of that weight loss while feeling good about themselves and their achievement.”

The program involves personal consultations with registered dietitians, exercise evaluations, support system assessment, and lifestyle evaluations, as well as the consultation with Gusenoff, who is fellowship trained in body contouring procedures. In addition to tummy tuck, body contouring procedures offered include thigh and buttocks lifts, arm lifts, female breast reshaping, male chest reshaping, face and neck lifts, and liposuction, depending on the nature and location of a person’s loose skin following weight loss.

Debra Wilson consulted with Gusenoff after shedding 80 pounds through healthier eating and regular exercise. Referring to herself as a “stress eater,” Wilson made numerous previous attempts to lose weight but said they were always motivated by a desire to improve her appearance.

“Then I found out I was pre-diabetic and had other health problems related to my weight. Now it’s about health and about seeing my grandchildren grow,” said the 57-year-old nurse and mother of four. Determined to improve her health, Wilson read books on combating diabetes through nutrition and reducing consumption of processed foods.

Changing the way she ate and taking her dogs for longer walks, Wilson went from her highpoint of 250 pounds to 170 in two years. Like Neale, the weight loss left Wilson with excess skin. She also had a skin condition which made the loose skin problematic.

Wilson consulted with Gusenoff who arranged for her to also meet with a nutritionist to help determine a course of action. She had a tummy tuck and breast lift last December and is thrilled with the results.

“My clothes fit better, I have more energy, and I feel better,” said Wilson.

Neale and Wilson both had medical conditions for which plastic surgery was indicated so some of the cost of their procedures was covered by their health insurance. That isn’t always the case, according to Gusenoff.

“Because cost is often a major factor in patients’ decisions regarding plastic surgery procedures, Life After Weight Loss provides financing options and counseling to assist making it affordable. Research has demonstrated that patient interest in plastic surgery following significant weight loss is very high, and that people have misconceptions about the costs associated with surgery,” Gusenoff said. “Our goal is to educate them and help them identify things they can do to make it attainable.”

Gusenoff, whose specialized surgical training and lifestyle coaching helps patients like Neale and Wilson experience the most satisfying, long-term results possible, collaborates with Highland Hospital bariatric physicians to provide safe and effective options to meet each patient’s goals and expectations. Together, they offer patients the most comprehensive options for pre- and post-surgical care. Highland Hospital has the region’s only bariatric center accredited by the American College of Surgeons, and performs more gastric bypass and lap-band surgeries than any other hospital in the area.

For information or to refer a patient to Life After Weight Loss, call (585) 276-LAWL or visit www.plastics.urmc.edu.